Digestive and Liver Disease - Volume 48 - Supplement 2

Abstracts of the 22

National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231

e153

occurred during colonoscopy in outpatient suffering from ulcerative

colitis (UC), which was successfully treated with endoscopic

clipping.

Material and methods:

In april 2015, we observed an outpatient

42 years old man with UC from 21 years, was sent at our hospital to

undergo a routine surveillance colonoscopy in our Unit of Digestive

Endoscopy. His past family and medical history, and physical

examination were unremarkable. Routine laboratory tests and

complete blood analysis were normal. The patient was in clinical

remission and actually treated with mesalazine 3,2 gr./daily. A total

colonoscopy, with conscious sedation and without the use of CO2

insufflation, at that time not available, was performed after standard

bowel preparation with 4 liters of polyethylene glycol lavage

solution using a split-dose regimen. Colonoscopic findings revealed

a mild erythema with granular mucosa in the rectum, and evidence

of multiple scars in left colonic segment explored.

Results:

During withdrawal of the endoscope, two longitudinal

MT with a length of about 8 and 12 millimiters involving mucosa

and submucosa were revealed in sigmoid colon, whereas such

MT were not observed during the insertion of the endoscope.

Therefore, immediately, ten endoclips Resolution ™ (Boston

Scientific Corporation, Natick, USA) were used for mucosal clousure

of the colon wall, without evidence of active bleeding. The patient

was hospitalized in the department of surgery, and to exclude the

suspicion of a perforation, an abdominal CT scan was performed,

which showed the absence of pneumoperitoneum. The patient’s

postoperative clinical course was uneventful, with a liquid diet and

parenteral antibiotic therapy, and he was discharged three days after

admission.

Conclusions:

MT are rare and uncommon complication during

colonscopy, have not been reported in the colonic mucosa of patients

with UC. Mucosal inflammation alone is not sufficient to explain the

cause of MT. One possible mechanism for MT could be attributed

to the stiffness of the mucosal and submucosal layers, as well as

the presence of multiple scars, possibly in combination with the

pressure of the air resulting from endoscopic insufflation, leading to

stretching of the colon wall mucosa and subsequent tearing.

P.06 Coeliac Disease 1

P.06.1

USEFULNESS OF LASER DOPPLER PERFUSION IMAGING TO

OBJECTIFY THE ORAL MUCOSA PATCH TEST IN THE DIAGNOSIS OF

ALLERGIC CONTACT MUCOSITIS IN NICKEL-SENSITIVE PATIENTS

Borghini R.*

, Puzzono M.

, Rosato E.

, Di Tola M.

, Greco F.

Di Nardi S.

, Picarelli A.

Department of Internal Medicine and Medical Specialties, Sapienza

University, Roma, Italy,

Department of Clinical Medicine, Clinical

Immunology Unit-Scleroderma Center, Sapienza University, Roma,

Italy

Background and aim:

Nickel (Ni) is often the trigger of gastro

intestinal and systemic disorders: the exposure of intestinal mucosa

to Ni may cause an Allergic Contact Mucositis (ACM), identifiable by

means of the Ni oral mucosa Patch Test (omPT). The effectiveness of

omPT has already been proven, but up today an objective diagnostic

approach to Ni ACM still lacks.

AIM: Laser Doppler Perfusion Imaging (LDPI) was tested to support

omPT in Ni ACM diagnosis.

Material and methods:

Popultaion: Group A: 22 patients with

intestinal and/or systemic symptoms related to the ingestion of Ni-

containing foods. Group B: 12 asymptomatic volunteers. Ni-related

gastrointestinal and/or extra-intestinal symptoms and their severity

were tested by a specific alimentary-symptom questionnaire. All

patients underwent Ni omPT with clinical evaluation at baseline

(T0), after 30 minutes (T1), after 2 hours (T2) and after 24-48 hours

(T3). LDPI was performed to evaluate the mean mucosal perfusion at

T0, T1 and T2. Statistical analysis was performed by ANOVA test and

Bonferroni multiple-comparison test.

Results:

All 22 Ni-sensitive patients (group A) presented oral

mucosa hyperemia and/or edema at T2. Eight out of the same 22

patients presented a local delayed vesicular reaction at T3 (group

A1), unlike the remaining 14 out of 22 patients (group A2). All 12

patients belonging to control group B did not show any alteration.

Mean mucosal perfusion calculated with LDPI showed an increase in

both subgroup A1 and A2. In group B, no significant perfusion

variations were observed.

Conclusions:

omPT properly supported by LDPI may actually be

used for diagnostic purposes in ACM to Ni. This also applies to those

symptomatic Ni-sensitive patients who do not have the typical

aphthous stomatitis after 24-48 hours from Ni omPT and could risk

to miss the diagnosis.

P.06.2

HOW MUCH DO CELIAC PATIENTS KNOW ABOUT GLUTEN FREE

DIET?

Bruno M., Marengo A., Bufis M., Sprujevnik T., Astegiano M.*

Ospedale Molinette, Turin, Italy

Background and aim:

The only treatment for Celiac Disease at

present is a strict lifelong gluten-free diet (GFD) which decreases

disease-related mortality and has a role in preventing some of the

long-term complications. Adherence to GFD has been the object

of many studies but few have investigated its essential requisite:

a thorough knowledge of gluten sources. Our aim was to measure

celiac patients’ knowledge of GFD and assess its determinants.

Material and methods:

Between March and December 2014 a 20-

item questionnaire was submitted to our celiac outpatients who

were asked to indicate which foods or situations might be at risk of

gluten intake. Half of the questions involved foods/situations that

really expose patients at risk of consuming gluten while the other

half concerned products that are gluten-free. A 20-point rating scale

was built giving one point for each correct answer.

Results:

154 patients were enrolled. The mean score of the

knowledge test was 14.3 ± 2.9. Focusing on the incorrect responses,

only 20.8% of them would have placed patients at risk of consuming

gluten while the other 79.2% concerned foods or situations that were

unnecessarily avoided by the patients. A statistically significant

lower score was obtained by patients aged over 60 years (p=0.0002),

without a degree or diploma (p=0.0016), non-members of the Italian

Celiac Association (p=0.043), who never logged to the Association

website (p=0.0002) and never ate outside (p=0.0009). Conversely

no significant correlation was observed between gender, kind of